农村环境改变了症状与肌缩性侧面硬化症的诊断之间的关联
Alexander A Hart1, Andrea Swenson2, Nandakumar S Narayanan2
1Department of Neurology, University of Michigan, Ann Arbor, MI, USA.
Amyotrophic lateral sclerosis & frontotemporal degeneration
|February 14, 2024
概括
在肌缩侧面硬化症 (ALS) 诊断之前的症状显著增加了诊断的几率,在城市和农村环境中观察到的变化. 早期识别症状可能会改善ALS查和诊断.
科学领域:
- 神经学 神经学
- 流行病学 流行病学
背景情况:
- 肌缩侧面硬化症 (ALS) 的诊断可能会被推迟.
- 识别预诊断症状对于及时干预至关重要.
研究的目的:
- 为了确定可能的ALS症状和随后的ALS诊断之间的关联.
- 调查这种关联是否在城市和农村人口之间存在差异.
主要方法:
- 利用了国家索赔数据 (Merative MarketScan,2001-2021) 对患有和没有ALS的个人.
- 匹配了19226例ALS病例与96,126例对照病例.
- 采用条件后勤回归来分析症状与诊断的关联以及城市/农村的变化.
主要成果:
- 患有ALS的人更有可能居住在城市地区.
- 84%的ALS患者至少有八种可能的症状之一,而对照组只有51%.
- 可能的ALS症状增加了ALS诊断的几率近五倍,观察到剂量-反应关系. 症状对诊断的影响在城市地区较小.
结论:
- 预诊断症状可能出现在ALS诊断前几年.
- 与城市患者相比,农村患者经历了较晚的诊断和更大的症状依赖.
- 这些发现表明,改善ALS查策略的潜力.
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